Apart from missing my family tremendously, I’ve been having a great time volunteering in Jamaica so far. On Friday was my first day going to Port Antonio and I’ve spent the last two days in Port Maria.

The patients and their parents have been very polite and grateful to me in general. I did see a mom today in Port Maria though who was frustrated at the tinea versicolor on her son’s chest and back which seemed to keep coming back despite her treatments and visits to the clinic. Her son had a classic rash. After giving her some selenium sulfide and some clotrimazole, she wanted oral medication which I didn’t feel was indicated. I did my best to explain that it can be a very frustrating problem in Jamaica as well as in the US. She was the exception though. Another parent totally made my day when he returned with his daughter today to bring me a bag full of ripe ackee fruit, freshly picked green bananas and plantain. I had seen his daughter in clinic the day before and she looked much better (OK, so she had a viral illness and got better on her own…fine). I was so happy, thanked him profusely. Unfortunately since I’m staying at the resort without any kitchen facilities, I had to give away my fruit to the nurses who were working with me.

Practicing medicine in a foreign country has its many rewards but also quite a few challenges that one can’t readily appreciate. There are different home remedies, different names of body parts, different perceived etiologies of disease and conditions that can totally throw you off while you’re talking to a patient. For instance, who knew that toilet paper can cause a vaginal infection or that a rubber band can give a child fungus in the hair? Plus, I’ve been totally inundated with all sorts of rashes that I would have been quick to refer to a dermatologist at home in the US. On top of that, there’ve been cases of measles in the area so I’ve been on the lookout for those potential cases as well. Luckily, the health department here has a rockin immunization program and parents are serious about giving their children shots.

Even as I say this, there is one similarity that I was surprised to find here in my rural clinic experience—pharm reps! Yes, I actually got approached with gifts and flatteries by a Jamaican pharm rep who handed me a printed bag, a pen, and a little speech on some new cough syrup for children…I was quite tickled about it. I actually would have appreciated a good ol’ Pharm lunch though—I was getting hungry. Too hungry and not enough energy to go into how I will be following my AAP recommendations and not prescribing cough syrup to children under 6, thanks very much.

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